| NPI | 1760725196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1700060) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.1700060) |
| 101YP2500X Counselor, Professional (Licence: OH C.1300161) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2023-07-27 |